Top 25 health insurance companies in the United State Of America (U.S.A) 2023

 Top 25 health insurance companies in the United State Of America: Offering health insurance is a major decision for employers, but knowing where to start can be overwhelming, especially for small businesses that don't have a human resources staff or a benefits specialist to assist.

However, putting in the time and research to set up a formal health benefit plan is well worth the effort. There are several advantages to offering an employer-sponsored health insurance plan, including helping to retain and attract employees, making your business stand out, and contributing towards a happy and healthy workforce. 

In this article, we’ll list the top 25 health insurance companies in the United States and share alternative health benefit options for employers interested in something other than traditional group health insurance plans.

Top 25 U.S. health insurance companies listed by market share

Understanding which health insurance companies are credible and offer a wide range of products and providers is a good place to start in your quest to provide great health benefits.

Below are the top 25 health insurance companies in the United States listed by size of market share in descending order:

1. United Health
2. Kaiser Foundation
3. Anthem Inc.
4. Centene Corporation
5. Humana
6. CVS Health
7. Health Care Service Corporation (HCSC)
8. CIGNA
9. Molina Healthcare
10. Independence Health Group
11. Guidewell Mutual Holding
12. California Physicians’ Service
13. Highmark Group
14. Blue Cross Blue Shield of California
15. Blue Cross of Michigan
16. Blue Cross Blue Shield of New Jersey
17. Caresource
18. UPMC Health System
19. Blue Cross Blue Shield of North Carolina
20. Carefirst Inc.
21. Metropolitan
22. Health Net of California
23. Local Initiative Health Authority
24. Point32Health
25. Blue Cross Blue Shield of Massachusetts

o clarify, the size of the market share doesn’t necessarily correlate with the quality of the product or medical service, nor does it guarantee the company will retain its position throughout the year. However, market share size is a good indication of competitiveness, financial health, and the structural security of the company, and insurers with higher market shares hold larger direct written premium amounts. 

How much do health insurance companies receive in premiums?

 During the COVID-19 pandemic, the CDC reported nearly 85 million COVID-19 cases throughout the U.S. As a result, the health industry reported almost a 14% increase—equalling $92 billion—in health benefit claims, which was a big jump compared to prior years. 

According to the 2021 NAIC Health Insurance Report1, U.S. health insurers earned approximately $890 billion in total net premiums. This was an 8% increase in premium spending from U.S. consumers over 2020. 

United Health, which takes the top spot in our list above, wrote roughly $195 billion in premiums over the past year. Blue Cross Blue Shield of Massachusetts, however, only wrote $8.4 billion. However, both of these companies saw an increase over the last year. 

Going forward, the health industry expects continuing increases in medical services needed due to delayed treatment over the past year, worsening health conditions, and older and higher-risk patients needing care. Considering this, employers of all sizes can better attract and retain their employees by offering a health plan and other additional benefits that will support necessary medical services in the coming years. 

Why HRAs and health stipends can be a better option for small employers

 With premium prices rising, it can be hard for small and midsize businesses to budget for group health insurance. However, there are more options for employers that can’t afford a traditional health benefit plan. Health reimbursement arrangements (HRAs) are one of those options. 

An HRA is a health benefit used to reimburse employees, tax-free, for out-of-pocket medical services, health insurance premiums, and other healthcare expenses. Employers can manage their budget by setting an allowance, and employees can gain more flexibility and freedom over their health benefits. Below we’ll go over four health benefit plan options that might be right for you and your employees.